Provider Demographics
NPI:1720461718
Name:STOVALL, ASHLEY (MSN APRN AGCNS-BC)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:STOVALL
Suffix:
Gender:F
Credentials:MSN APRN AGCNS-BC
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:SURBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN APRN AGCNS-BC
Mailing Address - Street 1:4300 CITY POINT DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8380
Mailing Address - Country:US
Mailing Address - Phone:178-284-1900
Mailing Address - Fax:817-595-0164
Practice Address - Street 1:12655 N CENTRAL EXPY STE 650
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1770
Practice Address - Country:US
Practice Address - Phone:214-819-9600
Practice Address - Fax:214-819-9601
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX840391364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist